Clinical effect of combined treatment by subgingival curettage and CO2 laser application

Abstract

Recent development of laser technology suggests a great deal of possibilities in the field of dentistry. The mechanism and safety of laser surgery is well established in many studies especially on the soft tissue applications. It has advantages including excellent hemostasis, visibility and less postoperative pain(claimed but undocumented)1,2. But from a periodontal point of view, much has yet to be proven. Several researchers have reported studies on laser applications to periodontal therapy. Cobb et al.3 and Ando et al.4 examined the in vivo bactericidal effect and concluded that the exposure of the root surface to laser could significantly decrease the levels of subgingival microflora of the patients with generalized adult periodontitis. Some studies have reported that the laser could reduce the number of curette strokes necessary for removing calculus5·Ito et al.6 reported that the laser irradiation effectively removed the smear layer, uncovered dentinal tubules, and exposed collagen fibers on the root surface. Many studies have also suggested efficacy of CO2 laser application on the root surfaces in vitro. There was an in vitro study which described the effectiveness of CO2 laser irradiation on the root surfaces removing the smear layer which could impede soft tissue attachment7. Crespi et al.8 found that more fibroblasts attached onto root surfaces CO2 laser applied in vitro. The objective of the present study was to evaluate the clinical effect of CO2 laser treatment when used in combination with conventional subgingival curettage through the measurement of clinical parameters.